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Bone Health: An Overview

What is osteoporosis and osteopenia?

Osteoporosis means “porous bone.” It is a disease of the bone that occurs as we age, and also can occur due to other medical conditions or from certain medications. Overtime bones lose structure, become weaker, and also our body does not generate new quality bone as rapidly. When the bones become porous, they become more fragile, making it easier to fracture your bones. A fall can cause a fracture and in more advanced stages, a fracture can even be caused by minor injury or sneezing.

 

Osteopenia is the precursor to osteoporosis. It is when the bones are weakened, but have not become fully soft yet. There is loss of bone density, but not low enough to be classified as osteoporosis. This condition is less severe, but still may warrant treatment with nutrition and lifestyle modifications to preserve bone quality and prevent progression to osteoporosis.

 

Your bone quality can be determined with a DEXA scan, which is a test that measures bone mineral density at different locations; the hip, spine, and forearm. This test is used to diagnose both osteopenia and osteoporosis, and is also used to monitor progression of the disease and to monitor improvement with treatment.

Risk factors and when to seek treatment?

-Post menopausal women
-Family history of osteoporosis or osteopenia
-Low body weight
-Long term use of corticosteroids (hydrocortisone or prednisone)
-Long term use of anti seizure medications
-History of eating disorder, celiac disease, inflammatory bowel disease, or other disease that affects absorption of nutrients
-Tobacco use
-Excessive alcohol use
-Low dietary intake of calcium or vitamin D

 

 

If you have any of these risk factors or have had fracture over the age of 50 you should consider seeing treatment. Women 65 years and older, and men 70 years and older are at age related risk for both osteopenia and osteoporosis and should have their bone health assessed.

 

How is it treated?

Osteopenia can usually be managed with proper nutrition, adequate intake of calcium and vitamin D, and regular weight bearing exercise which helps improve bone strength. If you have osteopenia but have also sustained a fracture, you will likely need treatment with medication that can help prevent further bone breakdown or help to build new bone.

 

Osteoporosis is treated with prescription medications, some medications help to prevent further bone loss and other medications can stimulate new bone growth. In addition to medication, we also recommend nutrition and lifestyle modifications.

 

For both osteoporosis and osteopenia we recommend smoking cessation, decreasing alcohol intake, and regular weight bearing exercise.

 

What can I expect at my visit?

At your initial consultation we will review and explain your DEXA scan results. If you have not had a recent DEXA scan, we will recommend obtaining one to assess bone quality.

 

It may be recommended that you have simple labs completed, to assess specifically calcium and magnesium, and vitamin D levels. Your parathyroid hormone may also be tested.

 

We will review calcium and vitamin D supplementation recommendations, as well as nutrition education. Discuss weight bearing exercise and other lifestyle modifications to help maintain bone. We will also discuss fracture prevention.

 

If treatment with medication is indicated, we will review medication options, explain risks and benefits.

 

 

For more information about both osteoporosis, osteopenia, treatment, and fracture prevention you can visit the following websites:

https://www.nof.org/
https://www.niams.nih.gov/Health_Info/Bone/default.asp
https://www.nia.nih.gov/health/prevent-falls-and-fractures